For more than a decade, Texas has maintained the highest rate of people without health insurance in the nation. More than 6 million Texans don't have health insurance. The Affordable Care Act requires most people to obtain health coverage in 2014, and sets forth a variety of ways to assist the uninsured. So far, only 207,500 Texans have obtained coverage through the federal health insurance marketplace. To measure the impact of ACA enrollment efforts, this interactive provides context on Texas' uninsured population.

While California, a more populous state, has a larger uninsured population, Texas has the highest rate — one in four Texans lacks health coverage — and the greatest number of children, 852,000, without coverage. The graph above shows the percent of people without health insurance in 2012 in the five most populous states and the nation based on five-year estimates from the American Community Survey conducted by the census.

Select Graph:

There isn't a simple explanation for why Texas' uninsured rate is so high. Texas has a relatively large number of retail, service and agricultural-sector jobs, which traditionally don't offer employment-based coverage. The state's lax regulatory approach to the individual insurance marketplace has led to high premium prices for people who are older, female or have pre-existing conditions. Although poor children may receive coverage through state programs, Medicaid eligibility in Texas is extremely limited for adults, especially compared to states like New York and Pennsylvania. And Texas has a large immigrant population, which accounts for more than 1 million of the state's uninsured.

These factors help explain why the majority of Texas' uninsured population is employed, and between the ages 18 to 34. To help this population find coverage, the Affordable Care Act allows young adults up to age 26 to stay on their parents' health plans, and offers tax credits to adults between 100 to 400 percent of the federal poverty threshold to purchase a health plan on the federal health insurance marketplace. The law initially required states to expand Medicaid eligibility to adults at or below 138 percent of the federal poverty threshold, but the U.S. Supreme Court ruled that provision should be optional.

Texas' Republican leadership has strongly opposed the law, and refused to aid enrollment efforts by expanding Medicaid eligibility or setting up a state-run health insurance marketplace. As a result, more than 1 million Texans fall into a "coverage gap," and don't have any assistance available under the Affordable Care Act. Still, local governments and community organizers are promoting enrollment in the federal marketplace.

Eligibility for Assistance Through the Affordable Care Act

Of the 6.2 million uninsured Texans:

874,000 are eligible for Medicaid/CHIP.

1,046,000 are in the coverage gap.

1,756,000 are eligible for tax credits.

1,264,000 are ineligible because of their income or access to employer benefits.

As of Feb. 2, 207,500 Texans had picked a health plan on the federal marketplace. The U.S. Department of Health and Human Services has released limited enrollment data that doesn't distinguish whether the people who've purchased health plans were previously uninsured. While most of Texas' uninsured popultion is younger than 34, the majority of the people who've enrolled are between the ages of 45 and 64.

As this Tribune animation explains, the plans offered in the federal marketplace are tiered. Bronze plans have the lowest premiums but cover fewer services and have higher deductibles, while platinum plans have the highest premiums, cover more services and have low deductibles. For people who are eligible for tax credits, the amount of the credit is based on their income and the cost of the second-highest-priced silver plan in the region. That partially explains why the majority of Texans have purchased silver plans.

Select Graph:

United States

Texas

California

Florida

Marketplace type

17 state-based; 7 state-federal partnership; 27 federally facilitated

Federally facilitated

State-based

Federally facilitated

Expanding Medicaid eligibility in 2014?

25 states + D.C. expanding; 25 states not expanding

No

Yes

No

As of Feb. 2...

Individuals determined eligible for marketplace plan

7,267,230

586,342

1,003,516

748,434

Individuals determined eligible for Medicaid/CHIP

3,181,155

80,368

850,000

99,746

Individuals who've selected a marketplace plan

3,299,492

207,546

728,086

296,892

Of those who've selected a health plan...

Without health insurance, many low-income Texans don't receive necessary health services. Although anyone can seek care at hospital emergency rooms, federal law only requires hospitals to stabilize a patient and usually won't provide treatments for serious diseases, such as cancer. Federally qualified health clinics that receive grants to subsidize basic care for low-income patients often have long wait times for an appointment and charge patients sliding-scale fees to cover their care.

Ultimately, hospitals, taxpayers and businesses foot the bill for people without sufficient health coverage. Texas hospitals reported $3.2 billion in charity costs and $2.1 billion in bad debt in 2010, according to the Texas Health and Human Services Commission. Although hospitals receive tax revenue, federal grants and donations to cover uncompensated care, the residual costs of caring for the state's uninsured or underinsured still topped $1 billion in 2010. Those additional costs lead to higher prices, and higher premiums for people who are uninsured.

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Actually Luisa, this story is more of an assault on objective journalism. The reporter still isn't telling us how many people LOST their health insurance due to Obamacare. She's also trying to inflate its popularity by reporting about 120k have signed up, but she still hasn't reported on how many of those signed up have actually bought into Obamacare by making a first payment. You can sign up all day for anything, but it doesn't mean much until you actually pay your dues.

If true, of the 6 million uninsured Texas citizens, only the 1,046,000 Texans, who are in the coverage gap without Medicaid expansion, will be uninsured after everyone else complies with the mandate for coverage under the ACA (Obamacare). The eligible children only have to be enrolled in CHIP/Medicaid and they're covered. The 1,756,000 eligible for tax credits and the 1,264,000 eligible for employer coverage have to be personally responsible and buy the insurance offered to them by their employer or in the Healthcare.gov exchange. The 1,226,000, who are ineligible because of their immigration status, will have to continue to receive healthcare in the many community clinics and emergency rooms across the state of Texas, until their immigration status changes.

A responsible #TxLege and Governor, along with the Congress of the United States and the President could easily take the actions necessary to improve the economy, healthcare and health insurance industry, and reform and enforce current immigration laws, if it was important to them. Otherwise, we'll have a repeat of the last fifty years, which has become progressively worse for the low and middle working class.

Since Texas doctors and hospitals routinely massively overcharge to pay their malpractice insurance when tort reform has made it almost impossible to sue for malpractice even when someone dies, I don't find it tragic that I don't buy health insurance, I'll probably live longer without it.

Articles like this ignore two big 800# gorillas in the room and by doing so makes it look like a piece just to make political points rather than real journalism.I am not a Republican and no Rick Perry... but that doesn't help explain the major issues involved or point to solutions.

Point 1... These stats are more of a damnation of our broken immigration system not Texas. If you factor out the number of illegal immigrants....which in Texas makes up 7% of the population (more likely....but who knows for sure...as they are undocumented) and perhaps 9-11% of the labor force. If you take that variable out of the equation, Texas...California, and Florida.... with high immigrant populations are much closer to the national average.

Point 2 In addition to illegals, Texas draws in a HUGE numbers of young adults and recent college graduate migrating in from rust belt states - many of which who take alternative or entry level jobs to get started or start their own small businesses and opt not to get health insurance to save money. Austin, where I live, is full of these kind of people. States with older more stable or declining populations are likely to have more people that are later in their careers or have already retired with a health plan. So a Michigan, Ohio, or say Indiana....states losing young people by the truck load to sunbelt states ....would be expected to have higher rates of insuranced workers. In general people who are 50 care about health insurance and have more options to get it, people who are 25 do not.Duh....

Something terrible has happened to the soul of the Republican Party, especially in Texas. We've gone beyond bad economic doctrine. We've even gone beyond selfishness and special interests. At this point we're talking about a state of mind that takes positive glee in inflicting further suffering on the already miserable.

there is a lot of misleading on this subject. I live in el paso texas and it has a population of over 700,00 and 85% hispanic. Texas in general has high hispanic population. A majority of the hispanic population does not want to pay for insurance and just wings it. it part of the culture . but o boy dont say that.

The deadline to pay for an Obamacare plan was Jan. 10, which was an extension. Originally, the deadline was Dec. 23. How can there not be any data by now? The media has given Obama a pass on this pertinent issue by omitting this question from the conversation. If an organization goes out to recruit new members saying we have so many sign up, but doesn't mention that a significant portion of those "signed up" haven't actually paid to become a member, don't you think that's a form of fraud? I know you can get semantic and legalistic about it, but honestly don't you think it's misleading? What's the plan -- get everybody signed up then garnish wages or tax returns when people don't pay? Or turn the "navigators" into collectors? When an important question gets omitted it's usually because there's a big rat behind it.

It seems to me that the Republican Party is just panting to do anything possible to destroy the ACA. Wish they would have used the same time, money, and energy to stop the two wars that Bush got us into without paying for them. Just think of how many American Lives would have been saved, and how many limbs would have been saved if we used that money to pay for Universal Healthcare!!!

I have to say that I hope that Obamacare helps other Texans liked it helped my family. Our insurance premium was about to be jacked by Aetna to $1200/month, for horrible coverage. Plan we just signed up for through exchanges took a chainsaw to those premiums, and increased our benefits and coverage, too! Texans: Check out the exchanges - they can and do help!!!

A friend...in MI was forced into end of life care by hte libtards there. He managed to get to TX...where he has gotten life saving care.....same gov't assist, but used properly. A recent MI, if it had happened in MI, would have been his death sentence.

For comparison, it would have informative had Massachusetts' Romney Care stats been included. The information would allow us to see what Obamacare looks like when fully implemented. The Texas lack of care is a disgrace considering there will be over $8 billion in the rainy day fund by the end of this biennium and most of Obamacare for the first three years is fully funded by the feds.

Good call Paul Martinez. Both Political parties have an agenda. Do not let your health be taken hostage people. Did anyone notice on the day of passing Obama care that the representatives were asked how they intend to pay for this $58 billion a year bill. Their reply was that they would regulate cost by delegating eligibility to procedure qualifications... ask anyone in healthcare what that really means.That means you better stay healthy. As for privacy laws and HIPPA... Kiss that goodbye. Now you sign paperwork that states that you have NO REASONABLE EXPECTATION to privacy. What does this really mean to you??? Think on it.

my classmate's step-mother makes $65 /hour on the computer . She has been fired from work for 8 months but last month her check was $17235 just working on the computer for a few hours. read this post here........... www.KeptMoney.com